Fodden D I, Crosby A C, Channer K S
Royal Hallamshire Hospital, Sheffield, United Kingdom.
J Accid Emerg Med. 1996 Nov;13(6):379-82. doi: 10.1136/emj.13.6.379.
To estimate the cardiac output produced by external cardiac compression during standard cardiopulmonary resuscitation performed by two groups of operators with different levels of experience and training.
Cardiac output was measured by Doppler aortovelography. All patients included in the study had necropsy examinations. Only patients without evidence of pulmonary embolism, myocardial rupture, aortic valve disease, or acute depletion of the intravascular volume were included.
31 patients presenting to the accident and emergency department suffering from non-traumatic cardiac arrest had cardiac output measurements made during resuscitation. Eleven patients were excluded after necropsy examination. The median cardiac index for the 20 study patients was 3.2 L min-1 m-2. The cardiac output produced by massage by less experienced personnel (median 1.2 L min-1 m-2) was significantly less than that produced by those fully trained in the technique (median 3.2 L min-1 m-2; P < 0.01 95% confidence interval -2.36 to -1.29). The amount of resuscitation related trauma was no greater than in other published series.
Differences in cardiac output during external cardiac compression are related to experience with the technique.
评估两组经验和训练水平不同的操作人员在进行标准心肺复苏时，胸外心脏按压所产生的心输出量。
采用多普勒主动脉流速描记法测量心输出量。纳入研究的所有患者均接受尸检。仅纳入无肺栓塞、心肌破裂、主动脉瓣疾病或血管内容量急性减少证据的患者。
31例因非创伤性心脏骤停就诊于急诊科的患者在复苏期间进行了心输出量测量。尸检后排除11例患者。20例研究患者的心脏指数中位数为3.2L·min⁻¹·m⁻²。经验较少的人员进行按压所产生的心输出量（中位数1.2L·min⁻¹·m⁻²）显著低于接受该技术全面培训的人员（中位数3.2L·min⁻¹·m⁻²；P<0.01，95%置信区间-2.36至-1.29）。复苏相关创伤量不高于其他已发表系列研究。
胸外心脏按压期间的心输出量差异与该技术的经验有关。
